Considerazioni su di un caso di anemia emolitica microangiopatica in soggetto con adenocarcinoma della colecisti

The authors report a case of hemolytic microangiopathic anemia (HMA) in a patient with gallbladder carcinoma with metastases to the liver, lymph nodes of the hepatic hilum, omentum, iliac bone and its bone marrow. After an overview of the literature on HMA and particularly in the peculiar mechanism of the small vessel damage, the clinical and laboratory picture is described. It is also underlined that this is the first case described in which the association of gallbladder adenocarcinoma and HMA is present. The progressive and fatal course of the disease is tied to the severe erythrocytic lysis and mechanical damage by the massive microembolization of small vessel walls by neoplastic cells. This also explains the complete uselessness of blood-transfusion therapy.